Search PubMed⌕ Search

Biomedical subjects

P Enoksson

Publications and source records attributed to P Enoksson.

At least 19 recordsLinked to original sources
PubMed1987

Transsphenoidal therapeutic puncture of a cystic pituitary adenoma.

Transsphenoidal diagnostic puncture of skull base tumours has been a routine procedure in Uppsala for a decade. Bromocriptine is the treatment of choice for patients with prolactin secreting pituitary adenomas. Here we report on a patient with a pituitary adenoma who instead developed an increase in tumour size after bromocriptine treatment. Magnetic resonance imaging showed the tumor to be cystic. A transsphenoidal puncture was used therapeutically instead of surgery with excellent result.

Adenoma↗
PubMed1986

Magnetic resonance imaging of tumours of the sellar region. Evaluation of treatment with bromocriptine retard.

Magnetic resonance imaging (MRI) with a superconductive 0.5 T magnet has been used in 10 patients with pituitary adenomas to evaluate the effect of bromocriptine treatment. Seven patients had prolactinomas, one a growth hormone (GH) producing adenoma and two patients null cell adenomas with slight hyperprolactinaemia. A single dose of 50 mg bromocriptine was given intramuscularly in a slow release preparation, followed after 6 weeks by 5 mg/day orally. Significant reduction of serum prolactin was noticed in all patients. Visual field defects disappeared rapidly. In all prolactinoma patients and in the patient with the GH producing adenoma MRI showed a decrease in tumour size. In 5 of these 8 patients MR signal analysis, aided by the use of a subtraction technique, clearly visualized the development of large intratumour cysts. In one further patient with a null cell adenoma there was also a rapid development of an intratumour cyst and an increase in tumour size. This patient was treated with transsphenoidal needle aspiration. In all tumour cases an increase in intensity quotients based on T1 and T2 relaxation times was calculated.

Adenoma↗
PubMed1984

Bromocriptine-induced regression of a suprasellar extending prolactinoma during pregnancy.

A 21-year-old amenorrheic woman with hyperprolactinemia had rapid pituitary tumor enlargment during a bromocriptine-induced pregnancy. Before treatment the sella turcica was normal. In the 31st week of pregnancy she developed bitemporal hemianopsia and markedly decreased visual acuity. Computerized tomography showed a pituitary adenoma with suprasellar extension. Reinstitution of bromocriptine therapy resulted in rapid recovery of normal vision and radiologically verified tumor regression. Pregnancy continued to term and a healthy child was born. If pituitary tumor complications should occur during pregnancy, reinstitution of bromocriptine is the primary treatment of choice.

Adult↗
PubMed1984

Screening for multiple endocrine neoplasia syndrome (type 1) in patients with primary hyperparathyroidism.

In 63 consecutive patients with primary hyperparathyroidism (HPT) a prospective screening study was undertaken for coexistent multiple endocrine neoplasma-(MEN)-syndrome type 1. The screening consisted of a clinical examination, a radiological examination of the sella turcica with skeletal tomography (and in equivocal cases computed tomography), visual field examination by perimetry and a hormonal evaluation including measurements of the serum levels of prolactin, gastrin, pancreatic polypeptide (PP) and subunits of human chorionic gonadotrophin (HCG-alpha and -beta). Clinical examination did not reveal any signs of endocrine disease suggestive of a MEN-1 syndrome. In only one case there was a radiological abnormality of the sella turcica; this patient had an empty sella syndrome and a raised serum prolactin value. All other prolactin values were within the normal range. In 41% of the patients raised serum gastrin levels were found; these tended to normalize after parathyroidectomy. As a group, patients with raised gastrin values were older than the others and generally they had hypo- or achlorhydria. The serum PP levels were raised in 28% of the patients but there was no clinical evidence of a pancreatic tumour in any of these cases, and the serum HCG-alpha and -beta levels were within the normal range in all patients but two. We conclude that the incidence of MEN-1 syndrome in unselected patients with primary HPT must be low, and that investigations for this syndrome are justified only in HPT patients with specific symptoms or with a positive family history.

Adult↗
PubMed1982

Bromocriptine-induced pregnancies in women with large prolactinomas.

Fourteen women with large prolactinomas experienced a total of nineteen bromocriptine-induced term pregnancies. None of the women had received prior pituitary tumour therapy. Post-partum sellar X-ray examinations showed signs of tumour enlargement in two women. Only one of them had clinical symptoms of tumour expansion with visual field defects during the pregnancy. The visual impairment improved when bromocriptine treatment was reinstituted and the pregnancy continued to term. The other twelve women had a total of seventeen uneventful pregnancies without symptoms or signs of pituitary tumour expansion. Thus, medical therapy with dopamine receptor agonists is the primary treatment for most infertile women with prolactinomas. The risk of serious pregnancy-induced tumour expansion is very small in properly investigated and carefully supervised patients with large PRL-secreting pituitary adenomas.

Adult↗
PubMed1982

Rapid regression of pituitary tumours during bromocriptine treatment of women with hyperprolactinaemia.

Four hyperprolactinaemic women with large pituitary adenomas with suprasellar extension were given primary tumour therapy with bromocriptine. The treatment resulted in rapid tumour regression in all the women, as verified by repeated computerized tomography (CT) scans. Pronounced visual field defects were present in three of the four women before treatment. All of them had marked improvement of vision within a few days after the initiation of bromocriptine therapy and they regained normal or nearly normal visual fields during the treatment. The raised serum prolactin concentrations decreased to normal levels in all the women. Thus, medical treatment with bromocriptine can induce rapid tumour regression in patients with hyperprolactinaemia and large pituitary tumours.

Adenoma↗
PubMed1981

Late (4-8 years) outcome of treatment with megadoses of fluphenazine enanthate in drug-refractory schizophrenics.

Fourteen schizophrenics who did not respond to standard doses of neuroleptics have been treated with megadoses of fluphenazine enanthate during a period of 4-8 years. Repeated attempts have been made to reduce the dose to the standard dosage. Some of the patients have gradually been transferred to maintenance treatment with standard doses, with megadoses given only during psychotic relapse. The megadose treatment has led to substantial reduction in social disablement, enabling the patients, for instance, to leave the hospital or live in an open ward. These patients have been evaluated with rating scales for psychopathology and side effects, and subjected to EEG, ECG, chest X-ray, and examinations for skin and eye changes and local infiltrations. Laboratory tests, including anti-DNA examination, have also been performed. These patients, treated with high total doses of different oral neuroleptics and fluphenazine depot, showed some EEG and ECG abnormalities, eye changes, slight leucopenia, a low number of staff nuclei neutrophils and infiltrations at the injection site, but these reactions did not result in any practical handicaps. The rating scales showed dyskinetic movements, usually slight, in six out of the 14 patients studied.

Adult↗
PubMed1980

Cerebral computed tomography in methanol intoxication.

In four of six patients with methanol intoxication, computed tomography (CT) showed necrotic changes in the area of the putamina. Hemorrhages were also seen in some cases. There was a clear relationship between the severity of the clinical symptoms and the CT findings, indicating the potential of CT for prognosis and possible therapy guidance.

Adult↗
PubMed1980

Follow-up study with computerized tomography and clinical evaluation 5 to 10 years after surgery for pituitary adenoma.

This study was based on 24 consecutive patients operated on for pituitary adenoma with suprasellar extension, and treated postoperatively with radiotherapy. The follow-up period was 5 to 10 years. A clinical examination, endocrine evaluation, perimetry, computerized tomography (CT) and sellar roentgenography were performed in 19 of 20 surviving patients. The CT scans revealed four recurrences, while perimetry only showed an increased visual field defect in one patient. Plain sellar films were of no value for diagnosis of recurrence. Prolactin determinations seemed to have a limited value in recurrence diagnosis, but very high levels spoke in favor of a recurrence. Thus, CT was found to be the superior method of diagnosing recurrences. It is proposed that CT be used regularly in the follow-up study of patients operated on for a pituitary adenoma.

Adenoma↗
PubMed1978

Altitudinal field defects and retinal nerve fibre degeneration in optic nerve lesions.

Altitudinal visual field defects in five cases with optic nerve lesions due to optic glioma, compression, and trauma are correlated to retinal nerve fibre degeneration, recorded with ophthalmoscopy and photography in red-free light. In one case the optic nerve was damaged at operation. Repeated fundus photography was used to record the evolution of descending optic atrophy. The results suggest that the findings in funduscopic examination of the retinal nerve fibre layer should be cautiously judged and the method cannot replace careful perimetry in cooperative patients.

Adult↗
PubMed1978

Haemangio-endothelioma of the orbit.

A case of infantile orbital haemangio-endothelioma was successfully treated with corticosteroids. Roentgenological and histological findings before and after treatment are described. It is suggested that an haemangio-endothelioma may be transformed into a cavernous angioma.

Female↗
PubMed1975

Double point test with the Goldmann perimeter.

A simple accessory to the Goldmann perimeter, permitting simultaneous projection of two targets, is described. The method can be used as a colour saturation test but also for the study of inattention hemianopia. Two cases illustrate its clinical application.

Female↗